Good news for erectile dysfunction sufferers: Relief is only a pill away. Some medications, like Cialis, are also prescribed to treat benign prostatic hyperplasia or BPH.

Erectile dysfunction causes can be attributed to many diseases and medical conditions known to cause ED. The first step treatment is ensuring that you are appropriately treating any underlying medical disease causing your ED.

For example, if you have diabetes, managing your blood glucose levels is not only critical for your overall health, but may help prevent worsening of your ED. If you have cardiovascular disease, treatment for your abnormal cholesterol levels or heart function may impact your erectile dysfunction symptoms.

If you are suffering from erectile dysfunction, it is important to discuss it with your healthcare provider so that the underlying cause can be identified and treated.

Lifestyle Modifications for Erectile Dysfunction

There are some measures you can take in your daily life to lessen or eliminate erectile dysfunction causes and to treat and prevent it.

• Exercise: Physical activity is good for your overall health but can also impact ED by helping to treat underlying causes. Exercise can reduce stress, improve blood flow, help regulate blood glucose levels, and improve your heart function all of which can help treat ED.
• Reduce your alcohol intake: Alcohol consumption, particularly excessive alcohol consumption, is linked with ED. Limiting your intake can help restore normal erectile function.
• Avoid recreational drugs: Drugs such as marijuana, cocaine, and heroin can all cause ED.
• Address psychological issues: Getting treatment for medical conditions such as depression or anxiety can play a big role in ED treatment for people suffering from them. Similarly, seeking counseling for relationship problems or taking measures to reduce stress in your life may also be helpful if those problems are contributing to your ED.
• Erectile dysfunction exercises: Pelvic floor muscle exercises, sometimes called Kegel exercises, have been shown to help treat ED. In fact, one study in the UK demonstrated that 40 percent of men with ED regained normal erectile function after beginning a pelvic floor muscle exercise regimen. An additional 33 percent saw significant improvement in their ED with the exercises. Most of these exercises involve engaging the muscles that help you stop urinating or that prevent you from having a bowel movement despite having an urge.

Oral Medications for Erectile Dysfunction

Medical treatment for ED was revolutionized in 1998 with the FDA’s approval of the first phosphodiesterase type 5 (PDE-5) inhibitor, sildenafil (Viagra). PDE-5 inhibitors work by preventing the breakdown of cyclic guanosine monophosphate, a key part of the erection-producing nitrous oxide-CGMP pathway.

When a man becomes sexually aroused, this pathway is activated which facilitates blood flow into the penis that is necessary for an erection. PDE-5 inhibitors essentially enhance this pathway but do require sexual arousal to be effective; in other words, they do not work in the absence of sexual arousal or stimulation. There are currently four PDE-5 inhibitors FDA-approved for ED:

• Sildenafil ()
• Tadalafil (Cialis)
• Vardenafil (Staxyn, )
• Avanafil (Stendra)

Because Sildenafil has been available longer than any of the other PDE-5 inhibitors, its efficacy has been studied the most. Studies have reported that anywhere from 36 to 76 percent of men who took sildanefil have been able to achieve an erection at least once. All of these medications, however, have side effects, some of which are a consequence of their enhancement of the nitrous oxide-CGMP pathway that causes blood vessel relaxation. The most common of these are headache (16 percent), flushing (10 percent), and nausea (7 percent).

All of these medications are prescription only and should be monitored by your doctor as they can interfere with other medications including nitrate drugs such as nitroglycerin and can cause significant problems in men with blood pressure problems, liver disease, or kidney failure. Doctors caution against the use of so-called “herbal Viagra,” which are supplements containing ingredients that mimic the effects of PDE-5 inhibitors but which are not regulated by the FDA and which may cause serious problems in men, particularly those with contraindications for PDE-5 inhibitors.

Testosterone may be given orally to men whose ED is linked to low testosterone levels. Testosterone can also be administered through intramuscular injections or through transdermal patches.

Non-oral Medications for Erectile Dysfunction

Alprostadil is a medication sometimes used for ED as an injection into the penis (Caverject Impulse or Edex) or as a suppository (Muse) inserted into the urethra, the tube through which urine and semen are emitted. Aprostadil contains prostaglandin E1, a chemical that dilates blood vessels. The primary side effects of aprostadil are minor bleeding and the formation of fibrous tissue in the penis where it is administered.

Erectile Dysfunction Equipment or Devices

Some men may find relief of their ED with the use of a penis pump, also called a vacuum erection device, or from penile implants. Penis pumps work by placing a tube over the penis. Such devices help pull blood into the penis by means of an attached pump that creates a vacuum effect in the tube. Your healthcare provider can help you determine whether this is an appropriate option for you and can guide you to the model that might help you most.

The main components of penile implants are surgically inserted inflatable or non-inflatable rods. Inflatable implants account for 80 percent of implants used and involve inserting a pump into the scrotum and the inflatable rods into the shaft of the penis. Non-inflatable rods are semi-rigid rods devices inserted into the penis that can allow the penis to be directed up or down. Implants are typically only used for men who have failed other non-surgical treatment options.

Originally published May 2016.